CH2 Scholarship Application Form
Name
First Name
Last Name
Email
example@example.com
Phone Number
-
Area Code
Phone Number
Date of Birth
-
Month
-
Day
Year
Date
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Academic Information
Grade or Year Level
Latest GPA Score
Latest GWA Percentile
Date Expected to Graduate
-
Month
-
Day
Year
Date
Are you a member of any organization in your school? Please provide information
Are you a member of any organization outside your school? Please provide information
Education Information
Name of School
Department
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
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Next
Parental Information
Name of Mother or Guardian
First Name
Last Name
Mother's Job/Position
Address of Mother
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Name of Father
First Name
Last Name
Father's Job/Position
Address of Father (if not the same as above)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Back
Next
Back
Next
Financial Information
Are you a dependent of your Parents?
Yes
No
Have you tried applying for scholarships with other organizations previously?
Yes
No
Any information that might support your answer above
Have you tried applying for financial aid?
Yes
No
Any information that might support your answer above
Upload your essay
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I AFFIRM THAT ALL STATEMENTS I HAVE INDICATED HEREIN ARE TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE. ANY MISREPRESENTATION I HAVE MADE CAN CAUSE FOR THE INVALIDATION OF MY APPLICATION AND SHALL BAR ME FROM RE-APPLYING FOR THE SAME.
Applicant's Signature
Name of Applicant
First Name
Last Name
Date Signed by Applicant
-
Month
-
Day
Year
Date
Submit
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